Nitrous Oxide - Community DentalCommunity Dental Nitrous Oxide Nitrous Oxide Nitrous Oxide - For a More Relaxing Dental Visit Imagine going to the dentist and feeling safe, warm and comfortable receiving dental care—without fear. It is possible, and for some it may be accomplished with nitrous oxide. Nitrous oxide is also known as inhalation sedation, laughing gas, nitrous, happy gas, and N2O-O2. Nitrous oxide is a colorless, odorless and tasteless gas which serves as a relaxant and is most commonly used in addition to local anesthesia (numbing medicine). It is administered via a mask placed directly over the nose while the patient breathes normally. It does not put the patient to sleep—you will still be able to hear and respond to your dentist. The gas is completely broken down by the body before the patient is discharged. With very few side effects, nitrous oxide gas is considered to be extremely safe to use in the amounts administered by dentists. While the experience will vary, most patients will enjoy a more relaxing dental visit—dental care without much of the anxiety often associated with procedures in the mouth. What is dental anxiety?

Dental anxiety is a real condition that can range from mild to severe, affecting women and men, young and mature individuals alike. It is fear of going to the dentist, receiving dental care, and dentistry in general. The fears may be of pain, helplessness, or loss of control. It may be due to a previous personal experience, knowledge of someone else’s unpleasant experience, or the negative portrayal of dentists in mass media. Fortunately, it does not have to prevent one from obtaining dental care. Nitrous oxide is one of several approaches specifically designed to help make the dental appointment more pleasant. Community Dental—Gentle, Safe, Comprehensive Dental Care Our approach is to work with you to develop a comprehensive treatment plan designed to improve and maintain your good dental health through preventive and restorative services. We participate with Mainecare as well as many dental insurance plans, and offer a sliding fee for eligible patients. We offer walk-in appointments during business hours for dental emergencies. We treat all ages, so your whole family can become established patients with us. Good oral health care is an important aspect of your overall health. Contact us today or give us a call—we have several locations throughout the state and look forward to your visit!

Nitrous Oxide - PsychonautWiki Nitrous Oxide Jump to: navigation , search Nitrous Oxide Above are nitrous oxide canisters. These are available for purchase on amazon and many other websites. They can be used with whip cream dispensers as an easy and convenient route of administration. Molecular structure of nitrous oxide Chemical Nomenclature Nitrous oxide, laughing gas, nitrous, hippy crack, NOS, nitro, N2O, Systematic name Dosage WARNING: Always start with lower doses due to differences between individual body weight, tolerance, metabolism, and personal sensitivity. See responsible use section . DISCLAIMER : PW's dosage information is gathered from users and resources for educational purposes only. It is not a recommendation and should be verified with other sources for accuracy. Summary sheet: Nitrous Oxide Nitrous oxide, commonly known as laughing gas, nitrous, nitro, NOS or hippy crack, [1] is an inorganic molecule and chemical compound with the formula N2O. It is an oxide of nitrogen. At room temperature, it is a colorless and non-flammable gas with a slightly sweet odor and taste.

It is used in surgery and dentistry for its anesthetic and analgesic effects. It is known as "laughing gas" due to the euphoric effects of inhaling it, a property that has led to its recreational use as an atypical dissociative anesthetic . The duration of these effects is approximately 2 - 5 minutes in length. It is also used as an oxidizer in rocketry and in motor racing to increase the power output of engines. At elevated temperatures, nitrous oxide is a powerful oxidizer similar to molecular oxygen. The gas was first synthesized by English natural philosopher and chemist Joseph Priestley in 1772, who called it phlogisticated nitrous air (see phlogiston). [2] It was first used as an anesthetic drug in the treatment of a patient when dentist Horace Wells demonstrated insensitivity to pain from a dental extraction on 11 December 1844. [3] Today it is used worldwide by hospitals and dentists alike as a general anesthetic.

The recreational use of nitrous oxide began at "laughing gas parties" primarily arranged for the British upper class in 1799 and has continued into modern times as the gas has become cheaper and more accessible to the masses. Contents 9 References Chemistry Nitrous oxide, or dinitrogen monoxide, has a linear chemical structure. It comes in two interchanging resonance structures: In one the central nitrogen atom is triple bonded to the other nitrogen atom and single bonded to the oxygen atom. The another form has the central nitrogen atom double bonded to both the other nitrogen atom as well as the oxygen atom. Both forms create formal charges on two of the atoms, which neutralize over the molecule. It was first synthesized by heating ammonium nitrate in the presence of iron filings and then passing the gas that came off (NO) through the water. Now it is commonly synthesized by gently heating ammonium nitrate to decompose it into nitrous oxide. Pharmacology Main article: NMDA receptor antagonist Although N2O affects quite a few receptors, its anesthetic , hallucinogenic , and euphoriant effects are likely caused predominantly or fully via its effects as an NMDA receptor antagonist .

[4] [5] NMDA receptors allow for electrical signals to pass between neurons in the brain and spinal column; for the signals to pass, the receptor must be open. Dissociatives close the NMDA receptors by blocking them. This disconnection of neurons leads to loss of feeling, difficulty moving, and eventually the famous “ hole ”. The pharmacological mechanism of action behind N2O in medicine is not entirely known. However, it has been shown to directly modulate a broad range of receptors and this likely plays a significant role in many of its effects. It moderately blocks β2-subunit-containing nACh channels, weakly inhibits AMPA, kainate, GABAC, and 5-HT3 receptors and slightly potentiates GABAA and glycine receptors. [6] [7] It has also been shown to activate two-pore-domain K+ channels. [8] Subjective effects Physical effects Spontaneous tactile sensations - The nitrous oxide "body high" starts off as the sensation of a diverse mixture of cold, warm, sharp, and soft tingles which begin across the head and face at lower dosages but spread out across the body at higher dosages.

Changes in felt bodily form - This usually occurs with higher dosages and can be described as feelings that in a non-painful fashion your body's physical form is being stretched into infinity, compressed into a singularity, or split into two separate halves. Dizziness - Although uncommon, some people report dizziness under the influence of nitrous. Headaches - Although uncommon, a certain subset of people report headaches during the offset of nitrous oxide. Motor control loss - A loss of gross and fine motor control alongside balance and coordination is prevalent within nitrous oxide and becomes especially active at higher dosages. This means that one should be sitting down before the onset unless they are experienced in case of falling over and injuring oneself. Perception of decreased weight - This creates the sensation that the body is floating and has become entirely weightless. It is often accompanied by feelings of slowly falling or drifting. Physical euphoria - This effect can range between mild pleasure to powerfully all-encompassing bliss. Anecdotal reports show that this sensation, which is taken advantage of by recreational users during sexual activities, can greatly enhance orgasm. [9] Tactile suppression - This effect partially to entirely suppresses one's sense of touch, creating feelings of numbness within the extremities.

It is responsible for the anesthetic properties of this substance. Cognitive effects Amnesia - At high dosages, it is often common for one to experience amnesia and memory loss after the experience has occurred. This is especially prevalent alongside ego death. Thought deceleration Unity and interconnectedness - During high dosage states of ego death, this component is a common but inconsistent accompanying effect. It occurs at level 4 - 5 and creates experiences of becoming one with the greater whole. In comparison to other hallucinogens which induce this effect, it can be described as comparatively simpler and less profound due to its more basic accompanying cognitive effects. Visual effects In comparison to other dissociatives such as Ketamine or DXM , the visual effects of nitrous oxide are comparatively simplistic. They progressively intensify proportional to dosage and can be broken down into five individual components which are listed and described below. Acuity suppression - Blurred vision to the point of all-encompassing blindness is a completely consistent effect within nitrous oxide even at moderate dosages. Frame rate suppression Double vision - This component is also prevalent at moderate dosages and makes reading incapable unless one closes an eye.

Pattern recognition suppression - This effect occurs at higher dosages and makes one unable to recognize and interpret perceivable visual data. Geometry - Nitrous oxide geometry can be described as unique in its behaviour. It usually only occurs at higher dosages and as a static wall of geometry which appears in front of one's vision alongside the physical sensation of becoming and merging with it. It usually manifests as consistently incidental in its form but varies in its arrangement between people. In terms of its stylistic appearance it can be described as simplistic in complexity, organic in style, unstructured in arrangement, colourful in scheme, glossy in shading, soft and blurred in its edges, large in size, still in movement, rounded corners, immersive in depth, and often based on complex interlocking circles. External hallucinations and Internal hallucinations - In comparison to other more classical dissociatives , hallucinations are particularly rare with nitrous but possible at high dosages. They exclusively occur at high levels, are capable of manifesting as both external and internal in style, and are usually delirious in believability (but commonly only include mundane scenarios such as perceiving and talking to people who are not currently present).

Auditory effects The auditory effects found with nitrous oxide, although simplistic, are famously known to be particularly intense and consistent in their manifestation when compared to other hallucinogens . These effects include: Distortions - These distortions are very powerful and loud enough in their volume to make the original sound completely unrecognizable. They include phasers, white noise, high pitch tones and notes, flanging, changes in pitch, echo effects, and stuttering. In particular, the frequency of the stuttering is proportionally related to the intensity of the effects, especially ego death which occurs when the stuttering becomes continuous. Suppression - This effect can be described as a muffling and quieting of externally sourced sound which results in it sounding more indistinct and distant than it would usually be. Combinations One of the most interesting application for nitrous oxide is not by itself but in combination with other hallucinogens to which it acts as a powerful and profound temporary potentiator of subjective effects. Psychedelics - When taken in combination with a classical psychedelic such as LSD or psilocin , the effect will be a sudden and dramatic increase in perceived geometry to its maximum level of 8A or 8B.

This is alongside a sudden and dramatic ego death. Dissociatives - When taken in combination with a classical dissociative such as MXE or DXM , the effect will be a sudden and dramatic increase in disconnective effects and the triggering of a sudden internal hallucinatory scenario. Cannabis - When taken in combination with cannabis, the overall effects of the nitrous itself are potentiated more so than the effects of the marijuana. Alcohol - When taken in combination with alcohol, adverse side effects such as confusion, dizziness, and headaches are often significantly increased. Experience reports There are currently no anecdotal reports which describe the effects of this compound within our experience index . Additional experience reports can be found here: Erowid Experience Vaults: Nitrous Oxide Available forms Canned whipped cream - These are found in any grocery store. They contain very minimal gas with one or two uses before the cream comes out. Chargers - These are readily available and cheap to purchase online. They are small metal canisters which can be used by a nitrous cracker to fill a balloon full of gas which is then inhaled. Some varieties contain industrial residue and strength vary (as it is food grade).

Medical tanks - These are hard to find and dangerous without a professional. They are occasionally seen at music festivals being used to fill balloons for sale. Toxicity and harm potential Nitrous oxide has been safely used as a mild anesthetic for over 150 years. The exact toxic dosage is unknown. Problems with its use come primarily from carelessness. Potential problems include: Brain injury and suffocation can result from lack of oxygen. When used as an anesthetic, nitrous is always administered in combination with oxygen. Never use nitrous in any manner that does not provide for adequate oxygen intake. Very cold temperatures of the gas can freeze the lips and throat if taken directly from a tank or whippet. Releasing the gas into a balloon first allows the gas to warm before being administered. Heavy and frequent long-term nitrous use can deplete vitamin B12 in the body and lead to serious and unpleasant neurological problems. Users may experience numbness and tingle in the fingers, toes, lips, et al. In more severe cases, there will be numbness of all extremities. Taking B12 supplements, especially in combination with a multivitamin and complete amino acid supplements, may help alleviate this problem.

If one experiences these symptoms, nitrous use should be ceased immediately, and if the symptoms persist, medical attention should be sought after. Nitric oxide, a toxic industrial gas, is occasionally mistaken for nitrous oxide. Users should be careful they know what they are inhaling. Inhaling Nitric Oxide can permanently damage the lungs or kill. It is strongly recommended that one use harm reduction practices when using this drug. Tolerance and addiction potential As with other NMDA receptor antagonists, the chronic use of nitrous oxide can be considered mildly addictive with a low potential for abuse. Tolerance to many of the effects of nitrous oxide develops with prolonged and repeated use. This results in users having to administer increasingly large doses to achieve the same effects. After that, it takes about 3 - 7 days for the tolerance to be reduced to half and 1 - 2 weeks to be back at baseline (in the absence of further consumption). Nitrous oxide presents cross-tolerance with no other psychoactive substances , meaning that after the use of nitrous oxide other dissociatives will not have a reduced effect. Legal issues United States - Possession of nitrous oxide is legal under federal law and is not subject to DEA purview.

[10] It is, however, regulated by the Food and Drug Administration under the Food Drug and Cosmetics Act. A prosecution is possible under its "misbranding" clauses, prohibiting the sale or distribution of nitrous oxide for the purpose of human consumption. Many states have laws regulating the possession, sale, and distribution of nitrous oxide. Such laws usually ban distribution to minors or limit the amount of nitrous oxide that may be sold without special license. For example, in the state of California possession for recreational use is prohibited and qualifies as a misdemeanor. [11] New Zealand - The Ministry of Health has warned that nitrous oxide is a prescription medicine, and its sale or possession without a prescription is an offence under the Medicines Act. [12] This statement would seemingly prohibit all non-medicinal uses of the chemical, though it is implied that only recreational use will be legally targeted. India - For general anesthesia purposes, nitrous oxide is available as Nitrous Oxide IP. India's gas cylinder rules (1985) permit the transfer of gas from one cylinder to another for breathing purposes. This law benefits remote hospitals which would otherwise suffer as a result of India's geographic immensity.

See also Nitrous Oxide experiences (Erowid) References ↑ Tarendash, Albert S. (2001). Let's review: chemistry, the physical setting (3rd ed.). Barron's Educational Series. p. 44. ISBN 0-7641-1664-9 . - ↑ Keys, T.E. (1941). "The Development of Anesthesia." Anesthesiology 2 (5): 552–574. Bibcode:1982AmSci..70..522D. doi:10.1097/00000542-194109000-00008. - ↑ Erving, H. W. (1933). "The Discoverer of Anæsthesia: Dr. Horace Wells of Hartford". The Yale journal of biology and medicine 5 (5): 421–430. PMC 2606479.

PMID 21433572 - ↑ "Effects of gaseous anesthetics nitrous oxide and xenon on ligand-gated ion channels. Comparison with isoflurane and ethanol" - ↑ Advances in understanding the actions of nitrous oxide - ↑ "Effects of gaseous anesthetics nitrous oxide and xenon on ligand-gated ion channels. Comparison with isoflurane and ethanol" - ↑ Effect of nitrous oxide on excitatory and inhibitory synaptic transmission in hippocampal cultures" - ↑ Two-pore-domain K+ channels are a novel target for the anesthetic gasses xenon, nitrous oxide, and cyclopropane - Swedish Pollutant Release and Transfer Register Nitrous oxide (N2O) Nitrous oxide (N2O), N2O Under normal environmental conditions dinitrogen oxide (more commonly known as nitrous oxide) is a colourless gas with a slight sweetish taste and odour. It is non flammable itself but will support combustion and is only slightly soluble in water. It has an anaesthetic and an analgesic property, offering pain relief when inhaled in sufficient amounts.

In the 19th century it was termed 'laughing gas' after the amusing effects it had on people that inhaled it. Use As a weak anaesthetic gas, nitrous oxide has been in use since the 19th century in medicine and dentistry. It is used in the dairy industry as a mixing and foaming agent as it is non-flammable, bacteriostatic (stops bacteria from growing) and leaves no taste or odour. In motor sport it is used to speed engines and it is even used in diving to avoid nitrogen narcosis and other effects experienced in deep dives. Major emissions Nitrous oxide is produced both naturally-from a wide variety of biological sources in soil and water-and anthropogenically by a variety of agricultural, energy-related, industrial and waste management activities. Nitrous oxide is also produced naturally in soils through microbial processes of nitrification and denitrification. The two major sources of man-made nitrous oxide emissions are in general agricultural soils and the manufacture of adipic acid (a feedstock for nylon manufacture) and nitric acids. Lower level emissions arise from combustion processes in the power generation sector and from road transport. Of the emissions from agricultural soils the most significant sources are fertiliser application and leaching.

Emissions from road transport are increasing as a result of the increasing number of petrol driven cars fitted with 3 way catalytic converters, since the converters produce significantly larger emissions of nitrous oxide. The contribution of road transport is minor but important because it is steadily growing in contrast to the other sectors which are declining. Impacts on human health and environment The main impact of nitrous oxide on the global environment is as a greenhouse gas, leading to global warming. Nitrous oxide is for many countries the third most important greenhouse gas, after carbon dioxide and methane. Although the emissions of nitrous oxide to the environment are smaller its global warming potential is 310 times that of carbon dioxide. The concept of global warming potential has been developed to compare the ability of each greenhouse gas to trap heat in the atmosphere relative to another gas. Nitrous oxide is also an ozone depleting substance causing damage to the ozone layer when it reaches the upper atmosphere. Nitrous Oxide NITROUS OXIDE Your Ultimate Resource for Anesthesia Meds! More on Nitrous Oxide Below - WIKIPEDIA AnestaWeb ::: Real People. Real Information.

NITROUS OXIDE Nitrous oxide , commonly known as laughing gas, is a chemical compound with the formula N2O. It is an oxide of nitrogen. At room temperature, it is a colorless non-flammable gas, with a slightly sweet odor and taste. It is used in surgery and dentistry for its anesthetic and analgesic effects. It is known as "laughing gas" due to the euphoric effects of inhaling it, a property that has led to its recreational use as a dissociative anesthetic. It is also used as an oxidizer in rocketry and in motor racing to increase the power output of engines. At elevated temperatures, nitrous oxide is a powerful oxidizer similar to molecular oxygen. NITROUS OXIDE Hospitals are administering nitrous oxide as one of the anesthetic drugs delivered by anaesthetic machines. Nitrous oxide is a weak general anesthetic, and so is generally not used alone in general anesthesia. In general anesthesia it is used as a carrier gas in a 2:1 ratio with oxygen for more powerful general anesthetic drugs such as sevoflurane or desflurane.

It has a MAC (minimum alveolar concentration) of 105% and a blood:gas partition coefficient of 0.46. When nitrous oxide is inhaled as the only anesthetic drug, it is normally administered as a mixture with 30% gas and 70% oxygen. The medical grade gas tanks, with the tradename Entonox and Nitronox contain a mixture with 50%, but this will normally be diluted to a lower percentage upon the operational dilevery to the patient. Inhalation of nitrous oxide is frequently used to relieve pain associated with childbirth, trauma, oral surgery, and heart attacks. - WIKIPEDIA Owned and Operated by AnestaWeb, Inc. * AnestaWeb ::: Disclaimer The contents of the AnesthesiaMedications.com or Anesthesiameds.com Website, such as text, graphics, images, and other material contained on the AnesthesiaMedications.com or AnesthesiaMeds.com Website ("Content") are for informational purposes only. This site provides only general information about medication. It does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned.

The information not intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The treating physician, relying on experience and knowledge of the patient, must determine dosages and the best treatment for the patient. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. AnestaWeb does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Site. Reliance on any information provided by AnestaWeb, AnestaWeb employees, others appearing on the Site at the invitation of AnestaWeb, or other visitors to the Site is solely at your own risk. ANESTHESIA MEDICATIONS Benzocaine , Lidocaine , Dibucaine , Pramoxine , Butamben , Tetracaine (Sprays, Ointments, Creams, Gels) What is Anesthesia? An anesthetic (anaesthetic), is a drug that causes anesthesia — reversible loss of sensation. They contrast with analgesics (painkillers), which relieve pain without eliminating sensation. These drugs are generally administered to facilitate surgery. A wide variety of drugs are used in modern anesthetic practice.

Many are rarely used outside of anesthesia, although others are used commonly by all disciplines. Anesthetics are categorized in to two classes: general anesthetics, which cause a reversible loss of consciousness, and local anesthetics, which cause a reversible loss of sensation for a limited region of the body while maintaining consciousness. Combinations of anesthetics are sometimes used for their synergistic and additive therapeutic effects, however, adverse effects may also be increased. Safety: The major safety hazards of nitrous oxide come from the fact that it is a compressed liquefied gas, an asphyxiation risk, and a dissociative anesthetic. Exposure to nitrous oxide causes short-term decreases in mental performance, audiovisual ability, and manual dexterity. Long term exposure can cause vitamin B12 deficiency, numbness, reproductive side effects, and other problems. The National Institute for Occupational Safety and Health recommends that workers' exposure to nitrous oxide should be controlled during the administration of anesthetic gas in medical, dental, and veterinary operators. What is the name of the compound N2O? | Reference.com What is the name of the compound N2O?

A: Quick Answer N2O is commonly known as nitrous oxide; however, it is also known as dinitrogen monoxide, nitros, NOS or laughing gas. It is a colorless gas that is used as an anesthetic and an analgesic. When inhaled, it can cause a mild form of hysteria, sometimes accompanied by laughter, and it decreases the sensibilities of pain. Full Answer Because nitrous oxide is stable and is a non-flammable gas, many motor sports cars as well as rockets use the gas as an oxidizer. An oxidizer adds oxygen to the mix when an engine fires and increases the power output of the engine. Motor sports use it for extra power, while rockets use oxidizers primarily because there is no oxygen in space, and oxygen is required during combustion. Laughing Gas - Nitrous Oxide - Relative Analgesia - Inhalation Sedation Inhalation Sedation Inhalation Sedation (Laughing Gas) Inhalation sedation, laughing gas, relative analgesia, RA, happy gas, gas and air, nitrous, nitrous oxide, N2O-O2… this one has more names than any other sedation technique! And deservedly so.

Inhalation sedation with nitrous oxide (N2O) and oxygen (O2) has been described as “representing the most nearly ‘ideal’ clinical sedative circumstance”… What is it? And what does it do? Nitrous oxide (N2O) is simply a gas which you can breathe in. It has no color, smell, and doesn’t irritate. It was discovered in 1772. Humphrey Davy (1778-1829), one of the pioneers of N2O experimentation, described the effects of N2O on himself following self-administration for a toothache and gum infection as follows: “On the day when the inflammation was the most troublesome, I breathed three large doses of nitrous oxide. The pain always diminished after the first four or five inspirations; the thrilling came on as usual, and uneasiness was for a few minutes swallowed up in pleasure.” Sounds like fun!! The extract above pretty much summarizes the effects of nitrous oxide: it kills pain – and it induces a pleasurable feeling. After 5 minutes or so of breathing in the gas, you should feel a euphoric feeling spread throughout your body.

It really kind of feels like a ‘happy drunk’ feeling. Some people find that there are auditory or visual effects as well. You will feel a bit light headed and often people get ‘the giggles’ (hence the name laughing gas!). As an interesting aside, nitrous oxide was one of the drugs of choice for young people in the late 1700s and early 1800s, when laughing gas demonstrations were a popular source of entertainment and enjoyment. First-hand accounts of Relative Analgesia “I started feeling warm all over. The elevator-type music they had on was starting to all sound the same and I could have sworn that they were looping the same song over and over and over. I remember somewhat the dentist coming in and telling me that this is going to be a “Three Martini Cleaning” and asked me if I preferred Strawberry Daiquiri or Pina Colada. The taste of Pina Colada filled my gums and then I saw the needle with the local anesthesia for a second, but he must have decided not to use it because I seriously didn’t feel anything.

I was already under a nice level buzz from the N20 and I could feel myself relaxing into the chair — the drugs were finally kicking in. The Pina Colada taste in my mouth made me start thinking of previous Caribbean vacations…” “I’m still smelling cherry flavor :-).You start with O2 of course and a few minutes later he asked how i was doing and basically nothing happened so he had to increase it a couple of times and finally I started to relax a bit. No real loopiness but just a sense of yeah I can get thru this. The biggest sensation was my legs felt kinda heavy as if to say maybe I want to stay here a while. Thinking like that I knew the gas was definitely working!! I WANTED TO STAY AT THE DENTIST!!!! Can you believe this.” How does nitrous oxide work? Today, we know that nitrous oxide (N2O) on its own can only safely be used for short periods of time (because the lack of oxygen in pure N2O can lead to unconsciousness and even death) – but that it’s safe to use for longer periods of time if you mix it with oxygen (O2).

Hence, the “laughing gas” used now is called N2O-O2, and contains at least 30% oxygen (that’s all the machines used nowadays will permit). Usually, the mix is about 70% oxygen to 30% nitrous oxide. In medicine, sometimes a mix of 50% oxygen to 50% nitrous oxide is used. This is known as entonox or, more commonly, “gas and air”. Depending on the concentration and length of administration of laughing gas, four levels of sedation can be experienced (after an initial feeling of light-headedness): a tingling sensation, especially in the arms and legs, or a feeling of vibration (“parasthesia”), quickly followed by warm sensations, and a feeling of well-being, euphoria and/or floating. During heavier sedation, hearing may dissolve into a constant, electronic-like throbbing. At a deeper level of sedation again, sleepiness, difficulty to keep one’s eyes open or speak (“dream”) can occur. Should nausea set in, it means you’re definitely oversedated! If you experience any unpleasant symptoms, let your dentist know so that they can adjust the percentage of N2O.

Alternatively, just take the mask off. During relative analgesia, you should stay within the first three stages. The “dream” stage means that the N2O concentration is too high, or that the gas has been administered for too long. This stage can be associated with side effects such as nausea and other potentially unpleasant sensations, including flashbacks. N2O concentration should always be gradually increased (“titrated”) at each visit, because people’s tolerance can vary from day to day. If you’ve had bad experiences with laughing gas in the past, it is highly likely that these were due to improper administration and too high a concentration of N2O. Interestingly, the actual mechanism of action of N2O is still unknown (it appears that there are quite a few different mechanisms at work)! However, it’s been observed that N2O depresses almost all forms of sensation – especially hearing, touch and pain, and that it seems to disinhibit some emotional centers in the brain. The ability to concentrate or perform intelligent acts is only minimally affected, as is memory. How is nitrous oxide administered? The equipment used for delivering “happy gas” is quite simple.

It consists of a supply of compressed gases and an apparatus which delivers the gases to the client. By turning some knobs and flipping on/off switches, the administrator can produce the desired mix of N2O-O2 in the desired quantities. Flowmeters and pressure gauges allow the administrator to keep an eye on the flow of gases. The desired N2O-O2 mix is fed through a tube to which a nasal hood or cannula is attached. This hood is put over your nose. All you have to do now is breathe normally through your nose – bingo! In modern machines there is a sort of double mask (see photo) where the outside mask is connected to a vacuum machine to suck away the waste gas – you wouldn’t want your dentist to get a face full of N2O… The white inside mask, which is placed over your nose, comes in lots of yummy scents – such as vanilla, strawberry, and mint! The one pictured to the left is scented with vanilla (that’s the one I’d go for), but Gordon likes the minty one best… The twin tubes running to the mask are for “gas in” and “gas out”.

The “gas out” line is attached to the vacuum machine, while the “gas in” line is attached to the RA (short for relative analgesia) machine. The inner mask is attached to the “line in”, you breathe out through a one-way valve in the inner mask, and the exhaust gas is collected inside the outer grey mask (pictured to your right) and sucked into the vacuum machine. What are the advantages of nitrous oxide? Nitrous oxide works very rapidly – it reaches the brain within 20 seconds, and relaxation and pain-killing properties develop after 2 or 3 minutes. The depth of sedation can be altered from moment to moment, allowing the person who administers the gas to increase or decrease the depth of sedation. Other sedation techniques don’t allow for this. For example, with IV sedation, it’s easy to deepen the level of sedation, but difficult to lessen it. Whereas with laughing gas, the effects are almost instant. Other sedation techniques have a fixed duration of action (because the effects of pills or intravenous drugs last for a specific time span), whereas gas can be given for the exact time span it’s needed for.

It can also be switched off when not needed and then switched on again (though to avoid a roller-coaster effect, you shouldn’t do this too abruptly). There’s no “hangover” effect – the gas is eliminated from the body within 3 to 5 minutes after the gas supply is stopped. You can safely drive home and don’t need an escort. With nitrous oxide, it’s easy to give incremental doses until the desired action is obtained (this is called “titration”). So the administrator has virtually absolute control over the action of the drug, preventing the possibility of accidental overdoses. While giving incremental doses is possible with IV sedation, it’s not possible with oral sedation (as a result, oral sedation can be a bit of a hit-and-miss affair). For certain procedures – those involving gums rather than teeth (e. g. deep cleaning) – it may be possible to use nitrous instead of local anaesthesia. N2O acts as a painkiller on soft tissues such as gums. However, its pain-relieving effects vary a lot from person to person and can’t be relied upon. No injection is required.

In cases of very severe needle phobia, getting laughing gas first can help you feel relaxed enough to allow the needle required for IV sedation to be inserted in your arm or hand. The very deep state of sedation achievable through IV sedation will then allow you to accept local anaesthetic. Inhalation sedation is very safe. It has very few side effects and the drugs used have no ill effects on the heart, lungs, liver, kidneys, or brain. Inhalation sedation has been found to be very effective in eliminating or at least minimizing severe gagging. Are there any disadvantages? Some people are not comfortable with the effects of laughing gas (either because they’re afraid they might lose control or because it makes them feel nauseous – this is quite rare, though, and usually due to oversedation). If you’re prone to nausea, it’s a good idea to have a meal (not a huge one) about 4 hours before your appointment. If that’s not possible (e. g. an early morning appointment), make sure your stomach isn’t completely empty – but don’t stuff yourself straight beforehand either.

According to Gordon, who’s a bit of an expert in the field, the normal working concentration of gases is about 70% oxygen to 30% nitrous oxide: “It’s rare to go beyond that because that’s what brings on the nausea, more than 45% N2O and you’re going to have the patient puke on you :grin:”. Some people will not achieve adequate sedation with permissible levels of oxygen. If you can’t breathe through your nose (either because you’re a pure mouth breather, or because your nose is blocked), or you feel too claustrophobic when something is put over your nose, it can’t be used. Depending on where you live, a dentist who offers nitrous oxide may be hard to come by. Apart from that, most of the disadvantages of inhalation sedation don’t affect you, but the dental team: there’s training required, the equipment is quite bulky and takes up a lot of space, and there is a possibility that dental staff who are chronically exposed to nitrous oxide might develop health problems.

The cost of the equipment and gases is high, so you’ll have to contribute to the cost – but it’s quite a bit cheaper than IV sedation. What about bad experiences with laughing gas? On rare occasions, people have reported a bad experience with nitrous oxide. Usually this is due to oversedation – getting too much N2O in the mix. This is easily reversible by reducing the amount of N2O. For example, a few people have reported auditory and “physical” hallucinations, dizziness, or vertigo. Don’t panic if you should experience this. While these symptoms are usually due to the N2O concentration being too high for you, the machines used nowadays have built-in safety features preventing an accidental overdose. Nonetheless, these sensations can be unpleasant – let your dentist know asap about any unpleasant sensations or symptoms so that they can adjust the percentage of N2O. Laughing, becoming giddy, crying, or uncoordinated movements are other signs that the NO2 concentration is too high, but these will easily be spotted by your dentist. Alternatively, just rip the mask off your nose!

Don’t confuse “dizziness” with the normal feeling of lightheadedness which many people who’ve never had N2O before experience after maybe 60 or 90 seconds. The feeling of lightheadedness will pass as the concentration of N2O is increased. Some experts in this field (e. g. Stanley Malamed) argue that nitrous oxide should always be “titrated”. This means gradually increasing the percentage of nitrous oxide in the N2O – O2 mix until a comfortable level is reached. The reason why titration should ideally be used every single time is because of potential adverse effects in the event of oversedation (including flashbacks of traumatic past events, as well as physical ill-effects). However, other experts (e.g. Fred Quarnstrom) say that it’s ok to use a mix based on prior experience (a concentration which a particular patient has experienced as pleasant during previous appointments). Quite a lot of dentists do this because it’s quicker. The problem with this approach is that tolerance can vary from visit to visit, depending on both psychological and physiological factors. What is experienced as pleasant varies from person to person and from day to day.

And once a person has been oversedated, they may come to dislike nitrous oxide so much that they don’t want to try it again. Are there any contraindications? There aren’t any major contraindications to relative analgesia, except for M.S., emphysema and some exotic chest problems. It hasn’t been proven to be safe during the first trimester of pregnancy, so you can’t use it then. Because you have to breathe it in through your nose, it’s not suitable for people who have a cold or some other condition which prevents them from breathing through their nose. You can’t be allergic to N2O. It’s also safe to use if you suffer from epilepsy, liver disease, heart disease, diabetes, or cerebrovascular disease. It is also used quite successfully in many people with respiratory disease – but it depends on the exact nature of the disease, so check with your dentist! How do I know if it’s for me? Why not ask if you can have a 5 minute ‘sample’ so that you know what to expect on the day of your procedure? Many thanks to Gordon Laurie BDS for his advice and help while writing this page – and for the photos.

Nitrous Oxide and Nitrite Inhalants: Just Say N2O To some people, nitrite inhalants and nitrous oxide are a lot of laughs. That's one reason the chemicals are popular among people looking for quick, cheap thrills. And nitrous oxide (commonly known as "laughing gas") and the nitrites mostly seem to fit the bill: They're cheap and easy to get (sometimes legally) in clubs and boutiques and through mail-order magazine ads. Still, that doesn't make them harmless. According to the best available data, nitrous oxide and other inhalants figure into at least 100 deaths a year in the U.S. alone. That's why we put together this pamphlet. Because once you start digging, you realize that nitrites aren't harmless, and some of the problems they cause aren't that funny, either. And the deeper you dig, the more dirt you discover. ..Amyl Nitrite & the High-Strung Heart More than 130 years ago, a chemical was developed to treat angina pectoris, a painful heart condition.

Until then, physicians had often treated heart disease with phlebotomy, a scientific name for the unscientific technique of bleeding a patient with leeches to rid the body of disease-causing "impurities." That's why angina sufferers were probably pretty pleased in 1867, when a British physician tried treating the condition with the new chemical, amyl nitrite. It worked -- in more ways than one. Because in addition to dilating the blood vessels of the heart (which eases angina pain), amyl nitrite also triggers a short, dizzying burst of euphoria. And it didn't take long for that fact to get noted by euphoria seekers, English and otherwise. ..Fast Forward: How Now Although it's still not clearly understood how, exactly, amyl works, what happens when it does sure is. Once inhaled, it triggers a quick jump in heart rate and drop in blood pressure and relaxes smooth muscle tissue. At the same time, it shuts off oxygen to the inner brain, producing a sudden, intense weakness and dizziness lasting 2-3 minutes. Sweating and flushing may also occur.

Still, if you need it, amyl nitrite is good medicine -- or was, before it was replaced by newer drugs. In fact, the drug was so effective -- and so relatively safe -- that it was sold over the counter for years, packaged in small mesh-covered vials. As time passed, though, amyl eventually found a larger market, one with healthy hearts -- particularly once word spread that the drug seemed to intensify sexual orgasm. Users dubbed the vials "poppers" and "snappers," due to the sound they made when crushed, and snapped up what they could from pharmacies. And even though amyl nitrite isn't an aphrodisiac and doesn't help in treating sexual problems, it quickly gained a reputation as a "love drug," especially among gay men. To counter exploding recreational use, the U.S. Food and Drug Administration reclassified amyl nitrite as a prescription-only drug in 1968. ..Butyl & Beyond: Pursuing Hex-Tasy When amyl passed into prescription-only status, a small swarm of little-known chemical cousins crept out of the closet and into the noses and lungs of a new generation of users.

The most popular early stand-in was butyl nitrite, a chemical that differs only slightly from amyl, but packs plenty of the same punch. Sold as a "room odorizer" or "liquid incense," to sidestep the U.S. Food & Drug Administration's regulatory authority, butyl was hawked under such trade names as "Locker Room" and "Jac-Aroma" -- which successfully conveyed the awful smell of the chemical: a scent hovering somewhere between month-old mildew and sweaty workout gear. That didn't stop the curious, though, from trying them and may even have added to butyl's cachet in the '80s, as use quickly spread from gay bars to dance clubs to the general public. Still, what happened to amyl eventually happened to butyl, too, as the U.S. Consumer Products Safety Commission stepped in where the FDA couldn't to ban the chemical in 1988. That only made the problem morph into something else. New act-alike chemicals appeared in almost-Biblical fashion (Amyl begat Butyl which begat Isobutyl which begat Isoamyl which begat Isopropyl) as each in turn was removed from the market by federal agencies.

Today, the newest nitrite is cyclohexyl nitrite, commonly sold as a "head cleaner" for VCR's, in a new effort to bypass controls. (For details, see the box below.) The chemicals remain popular due to their reputation as romance-enhancers and because they're a cheap, readily-available alternative to other drugs. Although butyl and the newer nitrites differ from amyl chemically, effects are roughly the same: a brief surge of dizziness and fluttering heart rate followed by sweating and flushing. Nitrites are known for the speed and intensity of their effects: A nitrite rush is near-instantaneous, but fades almost as quickly, leading most users to inhale more -- and often, more and more. And that's where the thrills can turn to chills, spills, and physical ills. ..Pressure Problems Short-term problems linked to use of nitrites are relatively minor, but can be painful nonetheless. Probably the best-known adverse effect is a feeling of pressure behind the eyes and a multi-megawatt headache. Other side effects include nausea, vomiting, faintness, and even blackout, particularly if the user is drinking or taking other drugs.

And given that many users sniff at crowded parties or in noisy bars or the middle of throbbing dance floors, nitrite blackouts carry special problems of their own. But those are just short-term effects. Frequent or long-term use of nitrites can pose additional risks, including: Glaucoma. Nitrites increase pressure in the nerves and blood vessels in the eyes, which may contribute to this blinding eye disorder. Blood Cell Damage. Nitrites damage red blood cells and may cause an often-fatal anemia in which blood can no longer transport oxygen. This type of poisoning happens most often to users who swallow (rather than sniff) the chemical and requires immediate medical treatment. HIV/AIDS. Researchers believe that nitrites may impair immune response and contribute to the onset of secondary infections often seen in people with AIDS. While excessive use of nitrites can be dangerous for anyone, some individuals are particularly sensitive to the chemicals' stimulant action. People suffering from anemia or high blood pressure or those who've experienced a recent head injury are particularly at risk. And pregnant women, of course, should avoid use of all inhalants (and all other unnecessary chemicals) to protect their unborn children.

..N20: 'Giggle Gas' Like amyl nitrite, nitrous oxide (N2O) is a medical drug with tons of history -- this time dating back to the 18th Century. Commonly known as "laughing gas," nitrous is colorless and sweet-smelling, and produces giddiness, relaxation, floating sensations, and a mild anesthesia. Medically, it's used for minor oral surgery and dental work. But that's only its day job. After hours, laughing gas moonlights as a recreational drug, particularly at concerts and clubs and alternative dance-culture events, or "raves." One source of N2O is whipped-cream containers, where it's used as a propellant. More commonly, though, the chemical is available in small canisters (known as "whip-its"), which are sold in head shops and through mail-order ads. Bigger industrial-strength cannisters find their way out of supply houses and dentists' offices and into the hands and heads of users via burglaries and diversion onto the black market.

And despite its long history of use and its wide margin of safety in medical practice, dangers linked to nitrous have increased in recent years as unsupervised use has mounted. ..Last Laughs Ready for another funny fact about N2O and the nitrites? Try this one: Commercial sales total in the tens of millions of dollars each year -- and that doesn't include the uncounted underground trade in nitrous oxide at concerts and raves. That's a lot of gas -- and a lot of dizziness, headaches, and other side effects. And that's not even the least funny/incongruous/weird part of the whole nitrite/nitrous oxide sniffing scene. Because some experts believe that nitrites produce only a physical reaction and that any psychoactive effect is, quite literally, all in the user's head -- it's just the brain trying to bounce back to normal and get a figurative grip on things. Then, if you add in the risks we've already discussed, you may just come to the same conclusion that millions of other people have -- that nitrites and nitrous oxide don't exactly add up to tons of fun after all. As conclusions go, you could do a lot worse.

..Sidebar 2 | Cyclohexyl: Nitrites 2000 The nitrites' most recent incarnation is cyclohexyl nitrate, commonly sold in head shops and adult book stores as a "head cleaner" for VCR's. Chemically, cyclohexyl is similar to its predecessors, amyl and butyl nitrite, with an industrial-strength odor that probably helps keep overuse down. Packaging is similar, too, right down to the warning label on the bottle: Caution: Flammable, harmful if swallowed, skin and eye irritant. If swallowed, drink two glasses milk or water, induce vomiting, call physician. For eye contact, flush with water. Avoid prolonged inhalation in confined areas. Keep out of reach of children. Ironically, the warning is printed on a plastic sleeve that peels away when the bottle is opened. And even though experts warn that such "cleaners" do more harm than good -- both to VCR heads and to users -- as long as there's a market for cheap thrills, there'll be cheap people thrilled to bring them to the market.

..Sidebar 2 | Nitrous Oxide: Clearing the Air One of the biggest casualties in the recent upsurge in use of nitrous oxide has been its long-held reputation for safety. Because as use has ballooned throughout the United States, so have reports of serious, even life-threatening risks linked to misuse. A main danger is the risk of suffocation. Users who sniff nitrous directly from a tank or a big enough balloon in a small enough space can pass out -- permanently, if nobody intervenes. Using nitrous in a car can be particularly risky. A lot of users do nitrous there, often with the windows rolled tight, to keep the gas from escaping. It works -- too well. The result is even more suffocation deaths -- along with a growing number of fatal car wrecks linked to the "toxic behavior" of nitrous users. There are other, less-lethal risks, too. Excessive use can cause nausea, vomiting, and disorientation, and since N2O impairs both motor control and coordination, it's a good idea to avoid inhaling it while standing. Want to avoid problems altogether? Then avoid nitrous oxide -- in fact, stay away from inhalants altogether.

They might look like a gas (even if they're a liquid or a goo), but they can turn life into a serious pain. This is one in a series of publications on drugs, behavior, and health by Do It Now Foundation. Please call or write for a complete list of available titles, or check us out online at .

Question: N2O or Nitrous Oxide is more commonly known as what?
Answer: Laughing gas